Mission and Responsibilities • “Better health care for all Floridians .” An Overview of the Agency for • The chief health policy and planning entity for the state: Health Care Administration – health facility licensure, inspection, and regulatory enforcement; – investigation of consumer complaints related to health care A Presentation for facilities and managed care plans; Florida’s Children and Youth Cabinet – implementation of the certificate of need program; – operation of the Florida Center for Health Information and Policy Analysis; By Elizabeth Dudek, Secretary – administration of the Medicaid program and contracts with August 31, 2011 the Florida Healthy Kids Corporation; and – certification of health maintenance organizations. AHCA.MyFlorida.com AHCA.MyFlorida.com Appropriation History Agency Funding Overview 25,000,000,000 Base Budget Fiscal Year (FY) 2011/12 21,639,857,976 FTE General Revenue State Trust Funds Federal Funds Total Administration & Support 297.0 $3,642,248 $17,018,967 $22,977,691 $43,638,906 20,000,000,000 19,400,622,938 Health Care Services 748.5 $3,559,885,273 $4,015,506,271 $11,658,697,497 $19,234,089,041 17,977,699,747 Health Care Regulation 617.0 $135,778 $29,481,954 $19,675,429 $49,293,161 16,608,344,729 16,393,581,338 Total 1,662.5 $3,563,663,299 $4,062,007,192 $11,701,350,617 $19,327,021,108 15,925,281,566 15,191,284,292 15,000,000,000 13,753,702,933 Base By Fund Type Base By Program 12,094,559,931 Budget General 10,377,344,072 Revenue Health Care 10,000,000,000 18% FTE Services 99.52% State Trust Funds 21% 5,000,000,000 1865 Federal Funds 61% Admin Health Care 1710.5 1707.5 1703.5 & Support Regulation 1685.5 1677.5 0.23% 0.26% 1672.5 1654.5 1662.5 - 1596.5 AHCA.MyFlorida.com AHCA.MyFlorida.com Division of Health Quality Assurance HQA by the Numbers • The Division of Health Quality Assurance (HQA) is • Number of active, licensed providers: 29,925 responsible for: – the state licensure and federal certification of health care • Number of licenses processed: 11,295 initial, renewal facilities and providers and managed care organizations, and Change of Ownership licenses processed – the review of architectural plans for health care facilities, – the investigation of consumer complaints against facilities and • Number of complaints investigated: 5,531 providers, – the provision of training to staff, and – the determination of need for certain health care facilities and • Number of background screenings: 209,012 criminal services. background checks conducted • HQA has eight field offices that serve as local liaisons to providers. AHCA.MyFlorida.com AHCA.MyFlorida.com
Children’s Treatment Facilities Children and Youth Hospitals • There are four intensive residential treatment facilities • Florida has three licensed children’s hospitals: with a total of 240 beds that serve children and – Miami Children's, All Children's, and Shriners in Tampa adolescents exclusively. – Nemours Orlando is under construction. – One hospital has 4 IRTF beds collocated with 26 child/adolescent inpatient psychiatric beds and 60 adult • There are at least 14 other hospitals that have named psych beds. their pediatric units “children’s hospitals,” but they are • There are three child/adolescent psychiatric hospitals, all units within general acute care hospitals. 66 child/adolescent beds and one child/adolescent psychiatric unit of 20 beds in Miami Children's • 62 Florida hospitals have NICUs with a total of 1,643 Hospital. beds. • There are 40 residential treatment centers for children – 28 of the hospitals have 697 Level III NICU beds. and adolescents with a total of 702 beds. AHCA.MyFlorida.com AHCA.MyFlorida.com Additional Children’s Facilities The Florida Center • There are approximately 40 licensed home health • The Florida Center for Health Information and agencies that primarily serve children. Policy Analysis is responsible for: – collecting, compiling, analyzing, and disseminating health • Five licensed nursing homes have dedicated children’s related data and statistics for the purpose of developing units and one nursing home serves only children. public policy, – promoting the transparency of consumer health care • There are 39 prescribed pediatric extended care centers information through www.FloridaHealthFinder.gov, with a total of 1,496 beds. – implementing the statewide health information exchange infrastructure, – administering the Medicaid electronic health record provider incentive program, and – collecting adverse incident reports. AHCA.MyFlorida.com AHCA.MyFlorida.com Data Specific to Children and Youth HQA Works with Children and Youth • www.FloridaHealthFinder.gov includes information • Although not clients, residents or patients served by about all patients discharged from the state’s hospitals AHCA-licensed providers may interact with other and ambulatory surgical centers. Discharge data can be Agencies for example children who live in health care sorted by age group, so detailed information is facilities or residential settings may interact with DCF, available about all pediatric conditions and procedures. APD, or DOH depending upon their needs and services. • The managed care Subscriber Assistance Panel offers an external review process for enrollees (including • The website also includes general health videos on children) of health maintenance organizations, prepaid topics of interest to people who care for children. health clinics and exclusive provider organizations when the plan’s internal grievance process has been exhausted. AHCA.MyFlorida.com AHCA.MyFlorida.com
The Division of Medicaid Medicaid by the Numbers • Number of Medicaid recipients as of June 30, • The Division of Medicaid is the medical assistance 2011: 3,029,133 program that provides access to health care for low- income families and individuals. • Number of enrolled providers as of July 2011: 115,821 • Medicaid assists aged and disabled people with the costs of nursing facility care and other medical • Number of active providers who submitted a claim expenses. between July 2010-July 2011: 74,034 • Eligibility for Medicaid is usually based on the family’s or individual’s income and assets. • Number of claims processed per month, on average: 13,278,295 • Medicaid has 11 field offices through the state. AHCA.MyFlorida.com AHCA.MyFlorida.com Medicaid Enrollment Medicaid Enrollment Age 0-20 July 2009-June 2011 Population Number of Youth % of total Medicaid Enrollment 3,100,000 Age 0-5 709,129 24% 3,000,000 2,995,439 2,997,952 2,973,095 2,975,720 Age 6-10 423,673 14% 2,965,383 2,961,095 2,900,000 2,920,498 2,913,826 2,917,026 2,898,569 Age 11-18 538,015 18% 2,861,411 2,800,000 2,821,123 2,804,783 Age 19-20 65,296 2% 2,788,484 2,751,875 2,758,016 2,731,697 2,700,000 2,727,362 2,707,447 2,698,247 Total Title XIX Medicaid 1,736,113 58% 2,679,941 2,667,662 2,640,036 Enrollment Age 0-20 2,600,000 2,608,834 2,500,000 2,400,000 AHCA.MyFlorida.com AHCA.MyFlorida.com Medicaid Expenditures for Florida KidCare Children’s Services • For FY 2009/10, 43.6% of the total Medicaid • Florida KidCare has functioned since its inception in expenditures were spent on Medicaid beneficiaries 1998 as an umbrella program that includes Medicaid, MediKids, Healthy Kids and the Children’s Medical under the age of 21. – Total expenditures: $14,588,622,385.34 Services Network. – For beneficiaries under 21: $6,369,708,115.62 • The Agency for Health Care Administration is the lead • Some of the major expenditure categories were: agency for federal and state funding and federal compliance, but KidCare does not have a designated – Inpatient services lead agency for overall administration and policy. – Physician services – Outpatient services – Prescribed medicines AHCA.MyFlorida.com AHCA.MyFlorida.com
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